Herlevic Vincent C, Mowad Ronald, Miller J Karen, Darensburg Nicholas A, Li Benjamin D L, Kim Roger H
Department of Surgery, Louisiana State University Health Sciences Center - Shreveport and the Feist-Weiller Cancer Center, Shreveport, Louisiana.
Department of Surgery, Louisiana State University Health Sciences Center - Shreveport and the Feist-Weiller Cancer Center, Shreveport, Louisiana.
J Surg Res. 2015 Oct;198(2):371-6. doi: 10.1016/j.jss.2015.03.088. Epub 2015 Apr 7.
Obesity has been associated with poor prognosis in breast cancer. However, most previous studies examined populations with relatively low proportions of obese patients. Given that forecasts predict obesity rates to exceed 50% by 2030, it is important to examine breast cancer outcomes in populations with higher rates of obesity. We hypothesized that obesity, as measured by body mass index (BMI), is associated with decreased overall survival and disease-free survival in patients with invasive breast cancer in a population with a high prevalence of obesity.
A retrospective review of a prospectively maintained database was conducted on patients treated for invasive breast cancer at an academic medical center between 1997 and 2013. BMI was calculated from each patient's height and weight at the time of diagnosis. Patients were categorized as normal (BMI <25 kg/m(2)), overweight (BMI 25-30 kg/m(2)), or obese (BMI >30 kg/m(2)), as per the definitions established by the World Health Organization. The end points of overall survival and disease-free survival were analyzed.
A total of 523 patients with invasive breast cancer were included for analysis. Based on BMI, 87 (16%) were categorized as normal, 150 (29%) were overweight, and 286 (55%) were obese. The median follow-up was 49 mo. There were 16 deaths (18.4%) in normal patients, 25 (16.7 %) in overweight patients, and 45 (15.7%) in obese patients (P = 0.84). By Kaplan-Meier survival analysis, there were no differences in overall survival (P = 0.49) or in disease-free survival (P = 0.33) among the three groups.
Obesity is not associated with decreased overall or disease-free survival in a patient population with a high prevalence of obesity. These findings suggest that there may be other factors that contribute to the poor prognosis of obese breast cancer patients observed in populations with lower rates of obesity.
肥胖与乳腺癌预后不良相关。然而，此前大多数研究调查的人群中肥胖患者比例相对较低。鉴于预测显示到2030年肥胖率将超过50%，在肥胖率较高的人群中研究乳腺癌结局很重要。我们假设，在肥胖患病率高的人群中，以体重指数（BMI）衡量的肥胖与浸润性乳腺癌患者的总生存期和无病生存期降低相关。
对1997年至2013年在一家学术医疗中心接受浸润性乳腺癌治疗的患者进行回顾性研究，这些患者的数据前瞻性地保存在数据库中。根据每位患者诊断时的身高和体重计算BMI。按照世界卫生组织制定的定义，患者被分为正常（BMI<25kg/m²）、超重（BMI 25 - 30kg/m²）或肥胖（BMI>30kg/m²）。分析总生存期和无病生存期这两个终点。
共纳入523例浸润性乳腺癌患者进行分析。根据BMI，87例（16%）为正常，150例（29%）为超重，286例（55%）为肥胖。中位随访时间为49个月。正常患者中有16例死亡（18.4%），超重患者中有25例（16.7%），肥胖患者中有45例（15.7%）（P = 0.84）。通过Kaplan - Meier生存分析，三组患者的总生存期（P = 0.49）或无病生存期（P = 0.33）均无差异。
在肥胖患病率高的患者群体中，肥胖与总生存期或无病生存期降低无关。这些发现表明，在肥胖率较低的人群中观察到的肥胖乳腺癌患者预后不良可能还有其他因素。
